How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $9,772.37 | Facility | None | $51.29 | $53.70 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $53.70 Typical High $95.50 | Professional | None | $46.77 | $53.70 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $23.99 Typical High $53.70 | Professional | None | $18.20 | $23.99 | $53.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $28.84 Median $44.67 Typical High $89.13 | Professional | 50 · Both sides | $28.84 | $44.67 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $66.07 | Professional | None | $25.12 | $34.67 | $66.07 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $24.55 Median $41.69 Typical High $79.43 | Professional | None | $24.55 | $41.69 | $79.43 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $147.91 | Professional | None | $36.31 | $46.77 | $147.91 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.70 Typical High $26.92 | Professional | 52 · Reduced service | $25.12 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $10.96 | Professional | 53 · Discontinued | $10.00 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $38.90 Typical High $40.74 | Professional | 54 · Surgery only | $37.15 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $8.13 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $5.37 |
Where New Hampshire sits
The same service costs 4.3 times more in Wyoming than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Hampshire· 36th of 51
$36.31
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.